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Te frst experience of performing transaxillary endoscopic surgery on the endocrine organs of the neck

https://doi.org/10.17238/2072-3180-2022-1-75-83

Abstract

Introduction. Te Kocher incision remained the only adequate access for operations on the thyroid and parathyroid glands for over 100 years. Te development of technologies made it possible to develop and introduce into clinical practice minimally invasive approaches to the endocrine organs of the neck, one of which is the endoscopic transaxillary.

Purpose of the study. To evaluate the results of the frst experience of performing endoscopic operations on the thyroid and parathyroid glands.

Materials and methods. From September 2018 to June 2021, 52 transaxillary endoscopic operations on the thyroid gland and 6 endoscopic parathyroidectomies were performed at the Department of Surgery of the Central Clinical Hospital of the Russian Academy of Sciences. Among endoscopic operations on the thyroid gland, 26 thyroidectomies, 17 hemiterioidectomies, and 9 extirpations of the thyroid lobe with an isthmus were performed.

Results. Te average time to perform endoscopic operations on the thyroid gland ranged from 82,5–12,1 minutes for hemithyroidectomy to 117.5–21.6 minutes for thyroidectomy about thyroid cancer. Te average bed-day was 4.5 ± 1.2 days. During the frst two days, all patients noted a slight pain syndrome, which was stopped by NSAIDs. Te main advantage of the operation, according to patients, was the absence of an incision in the neck. At the stage of mastering the technique, 2 intraoperative and one postoperative complications were noted.

Conclusion. Te frst experience in performing endoscopic transaxillary operations has shown the promising and safe access provided that the standard surgical technique is followed.

About the Authors

P. S. Glushkov
Central Clinical Hospital of the Russian Academy of Sciences
Russian Federation

 Glushkov Pavel Sergeevich – PhD, doctor of the Department of
Surgery

117593, Moscow, Litovsky bulvar 1A 



R. H. Azimov
Central Clinical Hospital of the Russian Academy of Sciences
Russian Federation

 Azimov Rustam Khasanovich – PhD, Head of the Department of
Surgery

117593, Moscow, Litovsky bulvar 1A 



K. A. Shemyatovsky
Central Clinical Hospital of the Russian Academy of Sciences
Russian Federation

 Shemyatovsky Kirill Aleksandrovich – Ph.D., doctor of the surgery department

117593, Moscow, Litovsky bulvar 1A 



V. A. Gorsky
Pirogov Russian National Research Medical University
Russian Federation

 Gorsky Viktor Aleksandrovich – MD, Professor of the Department
of Experimental Surgery

117997, Moscow, Ostrovityanova st., 1, building 7 



References

1. Ikeda Y, Takami H, Sasaki Y, Kan S, Niimi M (2000) Endoscopic neck surgery by the axillary approach. J Am Coll Surg, 2000, № 191(3), рр. 336–340. https://doi.org/10.1016/S1072-7515(00)00342-2

2. Belcevich D. G., Vanushko V. E., Melnichenko G. A. et al. Clinical guidelines of the Russian Association of Endocrinologists for the diagnosis and treatment of nodular goiter: (new edition of 2015). Endocrine Surgery, 2016, № 10 (1), рр. 5–12. (In Russ.) https://doi.org/10.14341/serg2015115-21

3. Belcevich D. G., Vanushko V. E., Melnichenko G. A. Rossijskie klinicheskie rekomendacii po diagnostike i lecheniyu differencirovannogo raka shchitovidnoj zhelezy u vzroslyh: 2020. (In Russ.) https://mosgorzdrav.ru/ruRU/science/default/download/629.html

4. Klinicheskie rekomendacii «Proflaktika infekcij oblasti hirurgicheskogo vmeshatel’stva», MZ RF 2018. (In Russ.) http://nasci.ru/?id=2260

5. Ohgami M., Ishii S., Arisawa Y., Ohmori T., Noga K., Furukawa T., Kitajima M. Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech., 2000, № 10(1), рр. 1–4.https://doi.org/10.1097/00129689-200002000-00001

6. Reshetov I.V., Sevryukov E.F., Golubtsov A.K., Krekhno O.P. Video-assisted resection of the thyroid gland from unilateral axillary access.Head and neck, 2014, № 3, рр. 15–19. (In Russ.)

7. Lyadov V. K., Nekludova M. V., Pashaeva D. R. Experience of transaxillary endoscopic thyroid surgery. Surgery. Pirogov Journal, 2016, № 11,рр. 4–7. (In Russ.) https://doi.org/10.17116/hirurgia2016114–7

8. Miccoli P., Bellantone R., Mourad M., Walz M., Raffaelli M., Berti P. Minimally invasive video-assisted thyroidectomy: multiinstitutional experience. World J Surg, 2002, № 26(8), рр. 972–975. https://doi.org/10.1007/s00268-002-6627-7

9. Rao R.S., Duncan T.D. Endoscopic total thyroidectomy. JSLS, 2009, № 13(4), рр. 522–527. https://doi.org/10.4293/108680810X12924466009249

10. Gagner M., Inabnet W.B. Endoscopic thyroidectomy for solitary thyroid nodules. Tyroid, 2001, № 11(2), рр. 161–163. https://doi.org/10.1089/105072501300042848

11. Miccoli P., Berti P., Bendinelli C., Conte M., Fasolini F., Martino E. (2000) Minimally invasive video-assisted surgery of the thyroid: a preliminary report. Langenbecks Arch Surg, 2000, № 385(4), рр. 261–264. https://doi.org/10.1007/s004230000141

12. Bellantone R., Lombardi C.P., Rubino F., Perilli V., Sollazzi L., Mastroianni G., Gagner M. Arterial PCO 2 and cardiovascular function during endoscopic neck surgery with carbon dioxide insufation. Arch Surg, 2001, № 136(7), рр. 822–827. https://doi.org/10.1001/archsurg.136.7.822

13. Ochiai R., Takeda J., Noguchi J., Ohgami M., Ishii S. Subcutaneous carbon dioxide insufation does not cause hypercarbia during endoscopic thyroidectomy. Anesth Analg, 2000, № 90(3), рр. 760–762. https://doi.org/10.1097/00000539-200003000-00046

14. Udomsawaengsup S., Navicharern P., Taravej C., Pungpapong S.U. Endoscopic transaxillary thyroid lobectomy: flexible vs rigid laparoscope. J Med Assoc Tai, 2004, № 87(2), рр. 10–14.

15. Miyano G., Lobe T.E., Wright S.K. Bilateral transaxillary endoscopic total thyroidectomy. J Pediatr Surg, 2008, № 43(2), рр. 299–303. https://doi.org/10.1016/j.jpedsurg.2007.10.018


Review

For citations:


Glushkov P.S., Azimov R.H., Shemyatovsky K.A., Gorsky V.A. Te frst experience of performing transaxillary endoscopic surgery on the endocrine organs of the neck. Moscow Surgical Journal. 2022;(1):75-83. (In Russ.) https://doi.org/10.17238/2072-3180-2022-1-75-83

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ISSN 2072-3180 (Print)